Evaluation of medical and surgical treatments for hidradenitis suppurativa using real-life data from the Scandinavian registry (HISREG)

Grimstad, T. Tzellos, D. N. Dufour, Bremnes, I. M. Skoie, I. Snekvik, E. Jarnæss, A. Kyrgidis, G. Ingvarsson

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background: Hidradenitis suppurativa (HS) substantially affects health-related quality-of-life outcomes. Most treatment options are supported by low quality of evidence without validated outcomes. Objective: The aim of this study was to evaluate the efficacy of surgical and medical interventions using physician- and patient-reported outcomes registered in HISREG. Methods: Data were extracted for all adult patients registered in HISREG between January 2013 and April 2016. Primary endpoints included Dermatology Life Quality Index (DLQI) scores, pain as measured using a numeric rating scale (NRS), Sartorius score and Hurley classification. Minimum clinically important differences (MCIDs) for DLQI and NRS pain were analysed. Secondary endpoints included comparisons among different treatment groups, safety and complications of various treatments. Results: Two hundred and fifty-five patients were included in the study: 31, 188, and 36 patients had Hurley stages I, II and III disease, respectively. Treatment with CO 2 lasers was the most common treatment modality. One hundred and forty-nine patients (58.4%) were treated with surgical intervention, 87 (34.1%) received antibiotics and/or anti-inflammatory treatments, and 19 (7.5%) were treated with both surgery and medical intervention. No patients received biologic treatment. In patients with surgical treatments, Sartorius scores were significantly improved compared with baseline (P = 0.001), 83 patients (55%) achieved a DLQI MCID, and 75 patients (49.7%) achieved an NRS pain MCID. In patients with medical treatments, Sartorius scores were not significantly improved compared with baseline (P = 0.582); 25 patients (28%) achieved a DLQI MCID and 28 patients (31%) achieved an NRS pain MCID. In patients treated with surgical and medical combination, 9 (48%) achieved DLQI and NRS pain MCIDs and Sartorius scores were significantly improved. Conclusions: CO 2 laser treatment is more effective than the non-biologic medical treatments in this analysis based on physician- and patient-derived outcomes. The study provides limited evidence for the combination of medical and surgical therapies in patients with HS.

Original languageEnglish
JournalJournal of the European Academy of Dermatology and Venereology
DOIs
Publication statusPublished - Jan 1 2019
Externally publishedYes

Fingerprint

Hidradenitis Suppurativa
Registries
Dermatology
Quality of Life
Therapeutics
Pain
Carbon Monoxide
Lasers
Physicians

ASJC Scopus subject areas

  • Dermatology
  • Infectious Diseases

Cite this

Evaluation of medical and surgical treatments for hidradenitis suppurativa using real-life data from the Scandinavian registry (HISREG). / Grimstad; Tzellos, T.; Dufour, D. N.; Bremnes; Skoie, I. M.; Snekvik, I.; Jarnæss, E.; Kyrgidis, A.; Ingvarsson, G.

In: Journal of the European Academy of Dermatology and Venereology, 01.01.2019.

Research output: Contribution to journalArticle

Grimstad ; Tzellos, T. ; Dufour, D. N. ; Bremnes ; Skoie, I. M. ; Snekvik, I. ; Jarnæss, E. ; Kyrgidis, A. ; Ingvarsson, G. / Evaluation of medical and surgical treatments for hidradenitis suppurativa using real-life data from the Scandinavian registry (HISREG). In: Journal of the European Academy of Dermatology and Venereology. 2019.
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title = "Evaluation of medical and surgical treatments for hidradenitis suppurativa using real-life data from the Scandinavian registry (HISREG)",
abstract = "Background: Hidradenitis suppurativa (HS) substantially affects health-related quality-of-life outcomes. Most treatment options are supported by low quality of evidence without validated outcomes. Objective: The aim of this study was to evaluate the efficacy of surgical and medical interventions using physician- and patient-reported outcomes registered in HISREG. Methods: Data were extracted for all adult patients registered in HISREG between January 2013 and April 2016. Primary endpoints included Dermatology Life Quality Index (DLQI) scores, pain as measured using a numeric rating scale (NRS), Sartorius score and Hurley classification. Minimum clinically important differences (MCIDs) for DLQI and NRS pain were analysed. Secondary endpoints included comparisons among different treatment groups, safety and complications of various treatments. Results: Two hundred and fifty-five patients were included in the study: 31, 188, and 36 patients had Hurley stages I, II and III disease, respectively. Treatment with CO 2 lasers was the most common treatment modality. One hundred and forty-nine patients (58.4{\%}) were treated with surgical intervention, 87 (34.1{\%}) received antibiotics and/or anti-inflammatory treatments, and 19 (7.5{\%}) were treated with both surgery and medical intervention. No patients received biologic treatment. In patients with surgical treatments, Sartorius scores were significantly improved compared with baseline (P = 0.001), 83 patients (55{\%}) achieved a DLQI MCID, and 75 patients (49.7{\%}) achieved an NRS pain MCID. In patients with medical treatments, Sartorius scores were not significantly improved compared with baseline (P = 0.582); 25 patients (28{\%}) achieved a DLQI MCID and 28 patients (31{\%}) achieved an NRS pain MCID. In patients treated with surgical and medical combination, 9 (48{\%}) achieved DLQI and NRS pain MCIDs and Sartorius scores were significantly improved. Conclusions: CO 2 laser treatment is more effective than the non-biologic medical treatments in this analysis based on physician- and patient-derived outcomes. The study provides limited evidence for the combination of medical and surgical therapies in patients with HS.",
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AU - Grimstad,

AU - Tzellos, T.

AU - Dufour, D. N.

AU - Bremnes,

AU - Skoie, I. M.

AU - Snekvik, I.

AU - Jarnæss, E.

AU - Kyrgidis, A.

AU - Ingvarsson, G.

PY - 2019/1/1

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N2 - Background: Hidradenitis suppurativa (HS) substantially affects health-related quality-of-life outcomes. Most treatment options are supported by low quality of evidence without validated outcomes. Objective: The aim of this study was to evaluate the efficacy of surgical and medical interventions using physician- and patient-reported outcomes registered in HISREG. Methods: Data were extracted for all adult patients registered in HISREG between January 2013 and April 2016. Primary endpoints included Dermatology Life Quality Index (DLQI) scores, pain as measured using a numeric rating scale (NRS), Sartorius score and Hurley classification. Minimum clinically important differences (MCIDs) for DLQI and NRS pain were analysed. Secondary endpoints included comparisons among different treatment groups, safety and complications of various treatments. Results: Two hundred and fifty-five patients were included in the study: 31, 188, and 36 patients had Hurley stages I, II and III disease, respectively. Treatment with CO 2 lasers was the most common treatment modality. One hundred and forty-nine patients (58.4%) were treated with surgical intervention, 87 (34.1%) received antibiotics and/or anti-inflammatory treatments, and 19 (7.5%) were treated with both surgery and medical intervention. No patients received biologic treatment. In patients with surgical treatments, Sartorius scores were significantly improved compared with baseline (P = 0.001), 83 patients (55%) achieved a DLQI MCID, and 75 patients (49.7%) achieved an NRS pain MCID. In patients with medical treatments, Sartorius scores were not significantly improved compared with baseline (P = 0.582); 25 patients (28%) achieved a DLQI MCID and 28 patients (31%) achieved an NRS pain MCID. In patients treated with surgical and medical combination, 9 (48%) achieved DLQI and NRS pain MCIDs and Sartorius scores were significantly improved. Conclusions: CO 2 laser treatment is more effective than the non-biologic medical treatments in this analysis based on physician- and patient-derived outcomes. The study provides limited evidence for the combination of medical and surgical therapies in patients with HS.

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